Evidence that specific personal relationships help regulate depressive symptoms and related constructs among people with probable major depressive disorder.

INTRODUCTION: Relational regulation theory describes how social network members (providers of regulation) help people (recipients of regulation) regulate their effect, actions and thoughts through mostly ordinary social interaction. Regulation is relational when the ability of a provider to regulate a recipient is an emergent property of the dyad and not a stable property of the provider or recipient. Research in predominantly well samples has found that dyads evoked affect and self-relevant thought in recipients. The present research examined whether such effects occurred among people with probable major depressive disorder (MDD). METHODS: A national, internet sample of 2058 US residents was screened for probable MDD. Depressed recipients (N = 152) rated their experience of depression-related constructs when with or thinking about specific providers. RESULTS: Recipients' reports of affect and thought varied strongly depending on the dyad they were with or thinking about. These effects occurred for depressive symptoms, positive and negative affect, self-esteem, negative automatic thoughts, hopelessness, excessive reassurance-seeking, reappraisal and emotion suppression. Dyads that evoked depression-related experiences were seen by participants as unsupportive and as evoking conflict. CONCLUSION: Relational regulation appears to occur among people with MDD which provides new insights about interpersonal processes in depression.

Pre-suicidal attempt: An intermediate type within ideation-to-action framework.

INTRODUCTION: Understanding the mechanisms of suicidal behavior is a prerequisite for suicide prevention and intervention. The current study aims to propose and verify the utility of pre-suicidal attempt as an intermediate type in the transition from suicidal ideation to suicidal attempt within the ideation-to-action framework. METHODS: A sample of 1084 college students completed a measurement package consisting of suicide history, suicide risk factors, and demographic information. Stratified stepwise multiple regression models and mediated moderation models were used to examine the relationship among the variables. RESULTS: Pre-suicidal attempts rather than suicidal ideation are predictive of suicide attempts. Age, depression, thwarted belongingness, fearlessness about death, perceived burdensomeness and suicidal ideation were predictors of pre-suicidal attempts. Supporting the interpersonal theory of suicide, pre-suicidal attempts mediated the relationship between suicidal ideation and suicidal attempts and were positively moderated by pain tolerance and fearlessness about death. The pre-suicidal attempters scored higher on fearlessness about death and suicide risk than the ideators, while pre-suicidal attempters scored significantly lower on suicide risk than suicide attempters. CONCLUSION: As an independent intermediate type within the ideation-to-action framework, pre-suicidal attempts contribute to deepen the understanding of the intermediate transition from suicidal ideation to suicidal attempts.

Perceived responsiveness in suicidal ideation: An experience sampling study in psychiatric patients.

INTRODUCTION: Perceived responsiveness, or the extent to which one feels understood, validated and cared for by close others, plays a crucial role in people's well-being. Can this interpersonal process also protect people at risk? We assessed whether fluctuations in suicidal ideation were associated with fluctuations in the degree of perceived responsiveness that psychiatric patients (admitted in the context of suicide or indicating suicidal ideation) experienced in daily interactions immediately after discharge. METHODS: Fifty-seven patients reported on suicidal ideation (5 times a day) and perceived responsiveness (daily) for four consecutive weeks. The effects of established risk factors-thwarted belongingness, perceived burdensomeness, and hopelessness-were assessed as well. RESULTS: The more patients felt that close others had been responsive to them, the less suicidal ideation they reported. At low levels of thwarted belongingness, perceived burdensomeness, or hopelessness, perceived responsiveness seemed to play a protective role, negatively co-occurring with suicidal ideation. When thwarted belongingness, perceived burdensomeness, and hopelessness were high, perceived responsiveness did not have an effect. CONCLUSION: Perceived responsiveness could be a protective factor for suicidal ideation for people at risk only when they are experiencing low levels of negative perceptions. When experiencing highly negative perceptions, however, perceived responsiveness seems to matter less.

Associations between fearlessness about death and suicidal ideation in individuals with psychosis.

BACKGROUND: Despite high rates of suicide among people with psychosis, relatively little is known about the mechanisms underlying the transition from suicidal ideation to behavior in this population. The Interpersonal Psychological Theory of Suicide (IPTS) proposes that fearlessness about death (FAD) may play a role in this relationship. The present study tested whether constructs of the IPTS [thwarted belongingness (TB), perceived burdensomeness (PB), and FAD] were associated with the severity of suicidal ideation in a sample of adults with histories of psychosis. METHOD: 261 adults with histories of psychosis completed measures of IPTS constructs, current severity of suicidal ideation, and history of suicidal attempts. We examined differences between those with past suicide attempts and those without and conducted regression analyses to evaluate the associations among TB, PB, FAD and severity of current suicidal ideation. RESULTS: Contrary to expectations, a history of suicidal behavior was not uniquely associated with FAD. Regression analyses revealed TB × PB and FAD × PB interactions emerged as significant correlates of the severity of suicidal ideation, with the relationship between PB and suicidal ideation more pronounced at higher levels of FAD and TB. Interestingly, positive symptoms of psychosis were positively associated with PB. IMPLICATIONS: This study provides support for broadening the investigation of FAD as a contributor to suicidal ideation in individuals with psychotic symptoms. Future research investigating the role of other contributors that may influence capability for suicide (e.g., impulsivity) may add additional understanding of suicide in this population.

Development and Initial Validation of the Parenting Styles Circumplex Inventory (PSCI).

Parenting style refers to the emotional climate in which parents nurture and guide their child's social development. Despite the prominence of parenting style research, many studies still create their own psychometrically untested measures of parenting styles, use measures that do not capture the uninvolved parenting style, or use median splits to convert dimensional assessments into parenting style typologies. To address these measurement issues, the current studies developed the Parenting Styles Circumplex Inventory (PSCI) which is rooted in Contemporary Integrative Interpersonal Theory and provides a framework to unite typology and dimensional parenting style measurement approaches. The current article describes the development and initial validation of the PSCI across three samples of college students (Ns = 571, 361, 385). The 32-item PSCI consists of eight octant scales which each assess unique combinations of parental responsiveness and demandingness. The measure asks respondents to answer each question about their mother- and/or father-figure. The circumplex structure of the PSCI was confirmed and replicated across studies and the PSCI demonstrated meaningful associations with indicators of parenting practices, relationship functioning, psychopathology symptoms, and substance use. Results from this study provide initial support for the PSCI as a path forward for measuring parenting styles.

Exploring the use of the Interpersonal Needs Questionnaire to examine suicidal thoughts and behaviors among Post-9/11 U.S. Combat Veterans: An integrative review.

This integrative review expands on the work of Kramer et al. (2020), by reviewing studies that utilized the Interpersonal Needs Questionnaire (INQ) to examine the interpersonal constructs (thwarted belongingness and perceived burdensomeness) of the Interpersonal Theory of Suicide (ITS) to understand suicidal thoughts and behaviors among service members and Veterans with combat experience. Very few studies (n = 9) in the literature were identified, however important relationships were revealed between combat exposure/experiences, thwarted belongingness, perceived burdensomeness, and suicidal thoughts and behaviors among military samples. Studies also reported risk factors for high levels of thwarted belongingness or perceived burdensomeness in military samples, such as moral injuries, betrayal, and aggression. This review highlights the utility of the INQ to measure ITS constructs among Post-9/11 U.S. Combat Veterans.

A longitudinal network analysis of suicide risk factors among service members and veterans sampled for suicidal ideation or attempt.

BACKGROUND: Suicidal thoughts and behaviors are elevated among active-duty service members (ADSM) and veterans compared to the general population. Hence, it is a priority to examine maintenance factors underlying suicidal ideation among ADSM and veterans to develop effective, targeted interventions. In particular, interpersonal risk factors, hopelessness, and overarousal have been robustly connected to suicidal ideation and intent. METHODS: To identify the suicidal ideation risk factors that are most relevant, we employed network analysis to examine between-subjects (cross-sectional), contemporaneous (within seconds), and temporal (across four hours) group-level networks of suicidal ideation and related risk factors in a sample of ADSM and veterans (participant n = 92, observations n = 10 650). Participants completed ecological momentary assessment (EMA) surveys four times a day for 30 days, where they answered questions related to suicidal ideation, interpersonal risk factors, hopelessness, and overarousal. RESULTS: The between-subjects and contemporaneous networks identified agitation, not feeling close to others, and ineffectiveness as the most central symptoms. The temporal network revealed that feeling ineffective was most likely to influence other symptoms in the network over time. CONCLUSION: Our findings suggest that ineffectiveness, low belongingness, and agitation are important drivers of moment-to-moment and longitudinal relations between risk factors for suicidal ideation in ADSM and veterans. Targeting these symptoms may disrupt suicidal ideation.

A Multi-Method Study of Interpersonal Complementarity and Mentalization.

Research finds cross-sectional relationships between mentalizing impairments and maladaptive personality traits. The current study connects mentalizing impairments to dynamic interpersonal processes using a multi-method design. A sample of 218 participants completed the Movie for the Assessment of Social Cognition (MASC; Dziobek et al., 2006) to assess mentalizing ability. Subsequently, participants rated their agentic and communal behavior and their perception of interaction partners' agentic and communal behavior over 21-days. Mentalizing ability moderated the within-person relationship between behavior and perception for both agency and communion. Worse performance on the MASC was associated with weaker interpersonal complementarity, suggesting that mentalizing impairments lead to deviations from expected patterns of behavior and perception across interpersonal situations. These findings confirm the assumption of Contemporary Integrative Interpersonal Theory that mentalization impairments can disrupt normative interpersonal processes (Cain et al., 2024; Pincus & Hopwood, 2012).

Relación entre la capacidad adquirida y el riesgo suicida / Relationship between acquired capacity and suicidal risk

La Teoría interpersonal del suicidio señala que la capacidad adquirida hace referencia a que la exposición repetida al dolor conlleva una habituación a estas experiencias, esto es lo que conlleva que el individuo, si cuenta también con la ideación suicida, pueda llevar a cabo el suicidio consumado. Por eso, el objetivo de este estudio es analizar las diferencias en la capacidad adquirida sobre la base de la existencia o no de riesgo suicida. Los resultados avalan los encontrados en otras investigaciones, observándose que, entre las personas con riesgo suicida y sin riesgo, existen diferencias estadísticamente significativas, siendo los que están en riesgo los que obtienen las medias más elevadas. Por lo tanto, la variable capacidad adquirida se muestra como una variable altamente relacionada con el riesgo suicida. (AU)

The Interpersonal Theory of Suicide states that acquired capability refers to the fact that repeated exposure to pain leads to habituation to these experiences, which is what leads the individual, if he or she also has suicidal ideation, to commit suicide. Therefore, the aim of this study is to analyze the differences in the acquired capability on the basis of the existence or not of suicidal risk. The results support those found in other studies, showing that there are statistically significant differences between those at risk and those not at risk, with those at risk having the highest mean scores. Therefore, the acquired capability variable is shown to be a variable highly related to suicidal risk. (AU)

Familism moderates the association between parent-child conflict, interpersonal needs, and suicidal ideation among adolescents.

Within the framework of the interpersonal theory of suicide, parent-child conflict in adolescence may be associated with suicidal ideation through increases in thwarted interpersonal needs (i.e., perceived burdensomeness and thwarted belongingness). Familism, a cultural value that emphasizes prioritizing familial interconnectedness and honor, may moderate the association between parent-child conflict and thwarted interpersonal needs. This study examined the relationship between parent-child conflict, familism, and suicidal ideation through the interpersonal theory of suicide. Participants were N = 250 psychiatrically hospitalized adolescents aged 12-17 years (Mage = 14.84, 60.8% female; 41.9% Hispanic, 21.5% African American/Black, 26.0% Caucasian). Participants completed survey and interview measures prior to discharge from psychiatric hospitalization. There was a significant conditional indirect effect of parent-child conflict on suicidal ideation through thwarted interpersonal needs [F (3, 246) = 54.41, p < .01], such that the strength of the indirect effects family conflict on suicidal ideation via thwarted interpersonal needs increased as familism increased. Findings indicate that the relationship between parent-child conflict and thwarted interpersonal needs may be exacerbated when levels of familism are also high. For youth who endorse high levels of familism, parent-child conflict may be particularly pernicious. Interventions targeting the family environment are needed to potentially improve adolescents' interpersonal functioning and protect against suicidal ideation.

Child and adolescent suicide is a growing and pressing problem, and it is currently the second leading cause of death among people aged 10­34. One theory of suicide, called the interpersonal theory of suicide, proposes that suicide ideation is related to two main risk factors: feeling that one's life is a burden on others (called perceived burdensomeness) and feeling like one is disconnected from others (called thwarted belongingness). In this theory, risk factors like parent-child conflict may be related to suicide ideation through increases in perceived burdensomeness and thwarted belongingness. It is possible that cultural values that prioritize family connectedness and honor (called familism) may also impact these relationships. The current study looked at how parent-child conflict, familism, and adolescent suicide ideation were related to one another in the context of the interpersonal theory of suicide. Participants in the study were 250 adolescents in a psychiatric hospital who completed survey and interview measures before being discharged. Results found parent-child conflict was related to suicide ideation through increases in one's perceived burdensomeness and thwarted belongingness (higher parent-child conflict was related to higher ratings of perceived burdensomeness and thwarted belongingness, which was related to higher ratings of suicide ideation), and the strength of the relationship between parent-child conflict, perceived burdensomeness, and thwarted belongingness increased as ratings of familism increased. These results indicate that parent-child conflict may have an especially strong relationship with thoughts of suicide in adolescents who also report a high level of familism. Therefore, suicide-related interventions that target the family environment may help prevent and treat adolescent suicide ideation.

An ecological momentary cognitive assessment study of over-attribution of threat and suicide risk factors in people with serious mental illness.

INTRODUCTION: People with serious mental illness (SMI; schizophrenia, schizoaffective disorder, bipolar disorder) are at increased risk of suicidal ideation (SI). Over-attribution of social threat, or attributing threatening emotions to neutral faces, may contribute to social isolation through increased social avoidance and decreased social approach motivation. These factors are related to suicide, as well as perceived burdensomeness (PB) and thwarted belongingness (TB). This study examined how over-attribution of threat relates to PB, TB, and social motivations. METHOD: N = 273 participants with SMI were assessed for current SI and behavior, and were stratified into SI (N = 130) vs. non-SI (N = 143) groups. Participants completed smartphone surveys (via ecological momentary assessments [EMA]) 3×/day for 10 days. They also completed the Mobile Ecological Test of Emotion Recognition (METER) 1×/day. Linear mixed models and multi-level mediation tested the relationships between over-attribution of threat, METER performance, PB/TB, and social motivations. RESULTS: Participants with and without SI did not significantly differ in over-attribution of threat or METER performance. In separate models, there was a relationship of over-attribution of threat with increased PB (B = 1.00, SE = 0.21, t = 4.72, p < .001), reduced social approach motivation (B = -0.74, SE = 0.22, t = -3.33, p < .001), and increased social avoidance (B = 0.90, SE = 0.24, t = 3.70, p < .001), all significant when adjusting for facial affect recognition ability. A model examining social motivations as a mediator between over-attribution of threat and PB/TB was not significant. CONCLUSION: These results suggest that over-attribution of threat relates to interpersonal constructs related to SI irrespective of facial affect abilities. This study may inform understanding of social cognitive processes related to suicide in SMI.

Examining the integrated model of the interpersonal-psychological theory of suicide and intersectionality theory among Black male adolescents.

INTRODUCTION: Guided by Opara et al.'s (2022), Integrated Model of the Interpersonal Psychological Theory of Suicide and Intersectionality Theory, the current study examined contextual stressors experienced disparately by Black youth (racial discrimination, poverty, and community violence) as moderators of the association between individual motivating factors for suicidal thoughts and behaviors (perceived burdensomeness, thwarted belongingness, and hopelessness) and active suicidal ideation. METHOD: Participants were 457 Black adolescent boys (mean age = 15.31, SD = 1.26) who completed self-report surveys. RESULTS: As predicted, the association between perceived burdensomeness and active suicidal ideation was significantly moderated by economic stress. In addition, the association between peer belongingness and suicidal ideation was significantly moderated by racial discrimination, but there were no moderating effects for school belongingness. Finally, the association between hopelessness and suicidal ideation was significantly moderated by both racial discrimination and witnessing community violence. CONCLUSION: These findings highlight the need for research, interventions, and policy work devoted to using integrated approaches of individual and socioeconomically relevant patterns of suicidal thoughts and behaviors to support Black youth exposed to various forms of structural oppression.

Development and psychometric properties of the Couple Interaction Pattern Scale.

This study developed the Couple Interaction Pattern Scale (CIPS) based on the interpersonal theory, comprising five subscales: friendly complementary (FC), hostile complementary (HC), mutual hostile-dominant (MHD), friendly-dominant eliciting hostile-submissive (FDHS), and hostile-dominant eliciting friendly-submissive (HDFS). The psychometric properties of the CIPS were examined through three independent studies. Study one conducted item reduction and preliminary analysis using a sample of 662 married individuals, with an additional 80 married individuals for test-retest reliability assessment. Study two validated the scale through 1207 married individuals. In study three, the effect of couple interaction pattern (CIP) on marital quality was analyzed among 310 newlywed couples using the actor-partner interdependence model (APIM). Results supported the construct validity, acceptable internal consistency, and test-retest reliability of the CIPS. Besides, concurrent validity was also proved by associations with conflictual communication patterns, marital quality, stability, emotional connection, and perceived partner support. APIM analysis also supported the association between CIP and marital quality.

Negative Urgency, (Lack of) Premeditation, and Sensation Seeking: Indirect Relationships with Suicidal Ideation through Thwarted Interpersonal Needs.

OBJECTIVE: Differences in how impulsivity is conceptualized, along with a myopic focus on impulsivity's relationship with historical suicidal behaviors, have resulted in limited implications made from prior research regarding impulsivity and suicidal thoughts and behaviors. The current study investigated the indirect effect facets of impulsivity may have on suicidal ideation, specifically, through thwarted interpersonal needs. METHODS: Participants were N = 424 undergraduate students who completed a cross-sectional survey. Participants completed the Urgency, Premeditation, Perseverance, Sensation Seeking, Impulsive Behavior Scale (UPPS), the Adult Suicide Ideation Questionnaire (ASIQ), and the Interpersonal Needs Questionnaire (INQ). Parallel mediation models were run to examine the relation between facets of impulsivity, perceived burdensomeness, thwarted belongingness, and suicidal ideation. RESULTS: Thwarted belonginess and perceived burdensomeness significantly accounted for the variance in the relation between negative urgency and suicidal ideation. Neither thwarted belongingness nor perceived burdensomeness significantly explained variance in the relation between (lack of) premeditation and suicidal ideation. Conversely, perceived burdensomeness and thwarted belonginess significantly explained the inverse relation between sensation seeking and suicidal ideation (i.e., greater sensation seeking was related to lower perceived burdensomeness and thwarted belongingness and in turn lower suicidal ideation). CONCLUSION: Negative urgency, in particular, is related to suicidal ideation through thwarted interpersonal needs. Future research should continue to differentiate between various types of impulsivity and its relationship with both suicidal ideation and behaviors utilizing both cross-sectional and ambulatory assessments of these constructs.HIGHLIGHTSNegative urgency is related to suicidal ideation.Negative urgency is related to thwarted interpersonal needs.Thwarted interpersonal needs partially explain the relation between negative urgency and suicidal ideation.

A Psychometric Evaluation of the Interpersonal Hopelessness Scale Among Individuals With Elevated Suicide Risk.

The interpersonal theory of suicide hypothesizes that suicide ideation (SI) emerges specifically in the context of hopelessness about the immutability of thwarted belongingness (TB) and perceived burdensomeness (PB; i.e., interpersonal hopelessness). The psychometrics of the Interpersonal Hopelessness Scale (IHS), which could be used to test this hypothesis directly, have not been rigorously evaluated. Participants (U.S. adults reporting past-year SI) completed online self-report assessments at Waves 1 (W1; N = 595) and 2 (W2; N = 215), 1 week apart. Confirmatory factor analyses supported a two-factor structure, IHS-TB and IHS-PB. Correlations indicated strong concurrent validity. Hurdle negative binomial regressions indicated that W1 IHS-TB and IHS-PB scores were associated with SI presence and severity at both waves, but this was inconsistent when adjusting for other W1 variables. IHS-TB and IHS-PB demonstrated excellent internal consistency and moderate to good test-retest reliability. The IHS could improve theory testing and suicide risk assessment and management.

Interpersonal theory of suicide and stressful life events in a clinical sample of adolescents in Spain.

AIMS: The interpersonal theory of suicide (ITPS) provides a theoretical model for suicidal behaviour. It includes two interpersonal variables, thwarted belongingness (TB) and perceived burdensomeness (PB). This study tested the relationship between ITPS interpersonal variables and suicide risk (presence/absence of suicidal ideation and suicide attempts throughout life) in a clinical sample of Spanish adolescents. We also assessed the potential mediation effect of these variables in the well-established relationship between stressful life events (SLE) and suicide risk. METHODS: We recruited 147 adolescents aged 11-17 from the Child and Adolescent Mental Health Outpatient Services of the Jiménez Díaz Foundation (Madrid, Spain). Different questionnaires were administered to assess suicidal behaviour and SLE (SITBI, The Stressful Life Events Scale) and to calculate proxy measures for ITPS interpersonal factors (SDQ, STAXI-NA, CDI). RESULTS: TB and PB significantly correlated with suicide risk. PB played a mediating role in the relationship between SLE and suicide risk: adolescents reporting SLE were more likely to enact suicide behaviours when they experienced higher PB. Patients scoring higher PB were more likely to receive more intense treatment but tended to abandon intervention promptly. CONCLUSIONS: ITPS seems useful for predicting suicide risk in an adolescent clinical sample. The results suggest an important role for PB in the SLE-suicide risk relationship and may impact the treatment process. Our exploratory findings should be addressed in future studies.

Fluidity in capability: Longitudinal assessments of suicide capability using ecological momentary assessments.

INTRODUCTION: Suicide capability is posited to facilitate the movement from ideation-to-action. Emerging evidence suggests capability comprises both trait- and state-like facets. This study examined fluctuations in and associations of acquired, dispositional, practical, and perceived capabilities, and suicidal mental imagery, and suicidal ideation. METHOD: Seventy-five adults (48 females, Mage = 36.53 years) with lived experience of suicidal ideation and/or attempt responded to four prompts per day for 2 weeks that assessed suicide capability and suicidal ideation. Mean-squared successive differences and probability of acute change indices and multilevel models were used for analyses. RESULTS: All facets of suicide capability fluctuated. Acquired and dispositional capabilities were trait-like, with practical and perceived capabilities being state-like. Suicidal mental imagery was the only facet of suicide capability that distinguished participants with a suicide attempt in the past 12 months from participants with a suicide attempt more than 1 year ago and suicide ideators. Suicidal mental imagery was associated with concurrent suicidal ideation and predictive of next assessment suicidal ideation. CONCLUSION: Suicidal mental imagery may be uniquely associated with suicide capability. This study suggests there are trait- and state-like facets of capability that can combine to potentially ready an individual to engage in suicidal behaviors.

Instagram Content Analysis in the Context of the Interpersonal Theory of Suicide.

The Interpersonal Theory of Suicide posits that interpersonal factors, specifically perceived burdensomeness and thwarted belongingness, increase suicidal ideation. Many modern social interactions take place over social media and, as such, examining social media content may offer a novel way to assess interpersonal relationships. In this preregistered study of 386 young adults, we examined the relationship between the amount of interaction with friends- and whether or not individuals interacted with family-related Instagram content and perceived burdensomeness, thwarted belongingness, and suicidal ideation. Instagram content was assessed via self-report and participants' Instagram profiles. Participants who endorsed interacting with family on Instagram demonstrated lower thwarted belongingness and suicidal ideation, but not perceived burdensomeness. Non-preregistered analyses of friend Instagram content demonstrated similar results. Consistent with the Interpersonal Theory, participants' interaction with family and frequency of interacting with friends on Instagram was associated with interpersonal variables and suicidal ideation but not aspects of acquired capability. Our study suggests that social media-based measures of interpersonal relationships are relevant to suicidality.

Generalisability of the interpersonal theory of suicide to latent profiles of young people attending treatment in a suicide prevention service.

OBJECTIVE: The Interpersonal Theory of Suicide (ITS) could help identify differences in groups of suicidal adolescents and inform treatment. METHOD: Latent Profile Analysis (LPA) using thwarted belongingness (TB), perceived burdensomeness (PB), hopelessness, and capability was conducted on data from an at-risk clinical sample (N = 500). The ITS prediction that changes in TB and PB are associated with changes in suicidal ideation was tested using admission and discharge data. RESULTS: Latent Profile Analysis identified three profiles with increasing complexity and severity on ITS factors. The profiles were labelled low-severity (7.6% of participants), moderate-severity (45.2%), and high-severity (47.2%). ITS predictions were partially supported for the full sample and only for the high-severity and moderate-severity subgroups, whereby changes in TB were significantly associated with changes in suicidal ideation over the course of treatment. However, changes in PB were only significant in the moderate-severity subgroup, and none of the ITS predictions were supported in the low-severity subgroup. Additionally, effect sizes for changes in TB and PB were modest in all analyses. CONCLUSIONS: Our findings highlight the importance reducing low belongingness in youth, which is a component of all supported interventions of youth suicide prevention. However, given the modest association of changes in ITS variables had with changes in suicidal ideation, it may be fruitful to elaborate on the relative importance on types of low belongingness or include other non-ITS variables.

Does the interpersonal theory of suicide explain relationships between muscle dysmorphia symptoms and suicidal ideation?

Muscle dysmorphia (MD) symptoms are robustly associated with suicidal thoughts/behaviors. Risk factors for suicidal ideation, such as perceived burdensomeness and thwarted belongingness, may help explain the relationship between MD symptoms and suicidal ideation. The current study extended past cross-sectional research by testing if perceived burdensomeness and/or thwarted belongingness mediated longitudinal relationships between MD symptoms and suicidal ideation. Two hundred and sixty-nine U.S. men recruited from Prolific completed self-report measures at three timepoints separated by one month each. Analyses used an adapted version of a longitudinal three-wave mediation model to test study hypotheses. Perceived burdensomeness mediated longitudinal relationships between MD symptoms and suicidal ideation. Thwarted belongingness did not show significant relationships with MD symptoms or suicidal ideation. Results extend past research by demonstrating that perceived burdensomeness may be a mechanism underlying longitudinal relationships between MD symptoms and suicidal ideation while establishing temporal ordering. Clinicians may consider targeting perceived burdensomeness in cases of comorbid MD/suicidality by using techniques that promote interpersonal effectiveness.